Introduction: This study examined the association between the extent of parental monitoring and sexual activity among middle school students in four African countries: Namibia, Zimbabwe, Uganda and Kenya. Sixty-three percent of HIV-infected individuals between the ages of 15-25 years live in Africa. Research indicates that parental monitoring which includes helping with homework and understanding troubles of youth influences adolescent sexual behavior. Methods: The data source for this study is the Global School-Based Student Health Survey (GSHS). The GSHS was administered in the four countries in 2003-2004. Students were classified as (1) never had sex, (2) sexually active but relatively low risk, or (3) high risk sexual activity including multiple partners or lack of condom use. Main effects multinomial logistic regression analysis used data from 7,887 students. Results: Nagelkerke R2 was 1.7%. Students whose parents never or sometimes understand their troubles are more likely to be sexually active or engage in high-risk sexual activity than students whose parents always understand their children's troubles. Students whose parents never or sometimes helped with homework are more likely engage in high-risk sexual activity than students whose parents always helped with homework. Parental knowledge of their children's daily activities did not help explain sexual activity. Conclusions: Parental assistance and understanding may reduce the likelihood that students are sexually active and engage in high-risk sexual activity. However, parental monitoring does not have a major effect on adolescent sexual activity. Subsequent research should consider other factors that influence sexual activity among this population.

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